The prostate is a gland forming part the male reproductive system and located immediately below the bladder, and plays a role in liquidity of seminal fluid. It consists of the cells responsible for secretion and their supporting peripheral tissues.
Prostate cancer arises from abnormal development of these cells that are responsible of secretion. In case of failure to make an early diagnose, prostate cancer spreads to peripheral tissues via lymph and blood vessels. It mostly involves the surrounding lymph nodes and bones. It may also spread to the lungs, liver and other organs.
It is calculated that 50% of men over 70 and almost all men over 90 have prostate cancer at microscopic level. The lifetime risk for a healthy man to contract prostate cancer is approximately 17%. This means that about one of six men contracts prostate cancer. Mortality rate was decreased after PSA test was discovered and used in clinical practices in 1980s. Although no exact statistics are available for the country, 250.000 men are diagnosed with prostate cancer each year in the USA and 95% of them are over the age of 45.
The cause of prostate cancer is unknown. As with the other types of cancers, adverse environmental conditions are considered to play role in development of prostate cancer together with genetic predisposition. The most important risk factors are age and family history. Investigation of cancer is recommended after 50 years old during routine check-ups; however investigations are initiated after 40 years old if the family has a history of prostate cancer. 10% of all prostate cancers are estimated to be inherited from father to son. The risk for male children or brothers of the patients with prostate cancer to contract prostate cancer is higher by 2-9 times.
There are different methods available for treatment of prostate cancer. Radical prostatectomy is the most effective one in these methods. The survival rate of patients with well-differentiated tumor who underwent a prostatectomy is higher than 90%. The radical prostatectomy is therefore the mostly preferred method among all treatment methods. Conventional open radical prostatectomy involves a large surgical incision. This results in longer postoperative recovery time; prolonged hospital stay; higher risk for site infection; and a larger scar on the patient. Robotic prostatectomy that has become common in recent years allows smaller incisions for procedure so the patients are offered a less traumatic minimally invasive treatment alternative.
Less blood loss – The abdomen is inflated with gas in robotic radical prostatectomy. The hemorrhage is reduced with this gas pressure. The gas is discharged from the abdomen when the procedure is finished. In addition, the hemorrhage can be clearly monitored by 3 dimensional high-definition cameras that can magnify the surgical site and prevented early. The patients usually need no blood transfusion.
Shorter hospital stay – The patients can be discharged from the hospital earlier than they can in case of an open surgery because of smaller incisions and less blood loss in robotic surgery.
Shorter time for catheter – The catheter is removed in 6-7 days by waterproof stitching of bladder to the urethra (anastomosis) in robotic prostatectomy.
Less pain – Patients feel less pain than they do with open surgeries because of smaller incisions.
Better control of cancer – In robotic prostatectomy, the surgeon has a clear view of prostate tissue with a 3 dimensional high-definition camera and instruments that can move at 7 degrees. The apical area of prostate can be clearly and well displayed and incised by robotic surgery. As a result, surgical border positivity is considerably reduced.
Better urinary control – Urinary control is achieved earlier in robotic prostatectomy than open radical prostatectomy. The factors that help achieve early urinary control include better image, less hemorrhage, and longer urethra
Early return to sexual life – With robotic prostatectomy, conversion of nerve fiber and vessel bundles surrounding the prostate is better performed in suitable patient so that the patients can back to their sexual life earlier.